Comparison of different criteria for the definition of insulin resistance and its relationship to metabolic risk in children and adolescents

Abstract

Childhood obesity frequently persists into adulthood, and is associated with insulin resistance (IR) and increased long-term morbidity and mortality. We compared IR criteria concerning 'age-specific cutoff points (ACOP)' and 'fixed cutoff points (FCOP)' for the identification of IR, and we investigated their correlation with metabolic syndrome (MS) Methods: The data were acquired from the 5 th Korea National Health and Nutrition Examination Survey (2010-2011). Participants aged from 10 to17 years underwent fasting plasma glucose, insulin concentrations and lipid panel measurements. High fasting plasma insulin levels or increased homeostatic model assessment insulin resistance (HOMA-IR) were defined as IR. We analyzed MS and IR frequencies according to FCOP or ACOP Results: Among 719 participants, 165 (22.9%) were overweight or obese based on their body mass index. We found no prevalence of MS in underweight/normal weight participants and 12.7 % prevalence rate in overweight or obese participants. IR according to ACOP was more closely associated with MS than IR according to FCOP. No differences were found in predicting the frequency of MS using FCOP or ACOP in both fasting plasma insulin and HOMA-IR. Conclusion: The frequencies of MS in participants with IR defined using ACOP and FCOP were similar. However, IR using ACOP was more closely associated with MS than IR using FCOP.

Impact of Insulin Resistance on Cardiometabolic Risk Factors and an Anthropometry-Based Predictive Nomogram for Insulin Resistance Among Adolescents in China

“…A previous study evaluated the frequencies of dyslipidemia and hyperglycemia in children with IR assessed by cutoff points of HOMA-IR; the frequencies of increased TC, LDL-C and TG, decreased HDL-C were all above 50% ( 35 ). Another study demonstrated that in a sample of Korean children and adolescents, metabolic syndrome increased 18.4-fold and each MetS component (including central obesity, hypertriglyceridemia, hypertension, low HDL-C, and hyperglycemia) increased 2.12–7.42-fold among participants with IR ( 40 ). However, they used different cutoff values of HOMA-IR for the diagnosis of IR.…”

Impact of the COVID-19 Pandemic on Seasonal Variations in Childhood and Adolescent Growth: Experience of Pediatric Endocrine Clinics

“…The rate of dyslipidemia in obese Korean adolescents is high and has been reported as 56.1%, and the 2017 clinical practice guidelines for dyslipidemia of Korean children and adolescents have been published [ 29 , 31 ]. Limited studies are available to define the risks of obesity-related comorbidities in Korean children and more studies are needed [ 32 , 33 ].…”

Metabolic syndrome definition in adolescents should incorporate insulin resistance

“…I read Lee et al's recent article in the Annals of Pediatric Endocrinology & Metabolism with great interest [ 1 ]. The authors demonstrated that the determination of insulin resistance (IR) through age-corrected cutoff points correlates more strongly with metabolic syndrome (MS) than the use of fixed cutoff points.…”

“…Despite IR being the main etiology of MS, the most widely accepted and used definition of MS from the International Diabetes Federation [ 5 ] does not use criteria for defining IR, but only places fasting glycemia as one of its diagnostic criteria. The article by Lee et al [ 1 ], as well as several others that have been published in recent years, clearly demonstrates that a suitable diagnosis of MS in adolescence needs to take into account IR. Several studies have demonstrated that fasting insulin or HOMA are appropriate indicators for this purpose.…”

“…To the editor, I read Lee et al's recent article in the Annals of Pediatric Endocrinology & Metabolism with great interest. 1) The authors demonstrated that the determination of insulin resistance (IR) through age-corrected cutoff points correlates more strongly with metabolic syndrome (MS) than the use of fixed cutoff points. This article is based on another paper published by the same group in 2014 2) that defined age-adjusted cutoff points for insulinemia and homeostasis model assessment (HOMA) in a Korean population.…”